Obstetrical device



Patented Mar. 26, 1940 Unites STATES f'ATENT 'orrlcs 4 Claims.

' The present invention relates to obstetrical devices, and more particularly to a suction cap adapted to fit upon'the head of the fetus, whereby it may be turned to: effect proper presentation I and'whereby traction may be applied to facilitate delivery.

One of the objects of the invention is to provide a device of this kind which will fit closely upon the head of the fetus and protect it from injuryand deformation, while at the same time permitting equalization of the suction. A further object is the provision of such a device which may be readily folded for insertion and which may be readily manipulated to any position for fetus orthe mother.

tachment of the suction tube.

interior thereof at l3;

' application regardless of the position of the head of the fetus. A still further object is to so reinforced as to distribute the force of traction and avoid deformation or other injury to the Still further objects of the invention, and the novel details of construction will be understood from the following specification describing an embodiment of the invention as illustrated in the accompanying drawing,

1, taken on line 22 of Fig. 3;

Fig. 3 is a View in transverse-section, taken on the line-33 of Fig. 2; and

Fig. 4 is a fragmentary view in longitudinal section, similar to'Fig. 2, showing a modified at- In the embodiment shown in the drawing the device comprises an oval cup-shaped body portion or cap H, having a flexible suction hose [2 attached thereto and communicating with the The entire device is preferably formed ofsoft rubber and, as shown in Figs. 1 and 2, thehose l2 may be vulcanized to the cap I I, or may be molded integrally therewith. As shown in Fig. 4, the hose l2 may be attached to the cap ll by a rigid tubular member M, of metal, hard rubber, or other. suitable material, having flanges l5 and I5 engaging in the cap ll and having a projecting portion to which the hose ill may be secured.

A transversely extending extension I1 is provided on the top of the cap, such extension being preferably of a length equal to about half the width of the cap and having an opening l8 extending from end to end, the extension thereby forming a loop in which a finger may be inserted wins-361) from either end to apply traction to the cap as a whole. The wall of the cap-is preferably slightly thickened for a width corresponding to the transverse extent of the extension H to form a reinforcing ridge [9 of uniform width that I extends to the front and rear edges of the cap.

An additional narrow reinforcing rib 2B is prefe'rably provided, ext-ending lengthwise of the cap over the center of the extension H and merg ing into the top surface of the ridge 19 just short ofthe front and rear margins of the cap. The side walls 2! of the rib 20 constitute abutments which may be engaged by the fingers of the opera-tor to facilitate rotative' movement of, the fetus. It will be understood that the thickness of the ridge l9 and the rib 2D is only sufficient to assist in distributing the force of traction, without materially decreasing the flexibility of the device, and that the extension or loop 11 is sufiiciently flexible that it may be collapsed downwardly toward the top of the cap.

A further reinforcement 22 is preferably pro-f vided at each side of the cap by thickening the wall over an area between a line uniformly spaced at 23 from the lateral margin of the cap and a line uniformly spaced at 2-1 from the side wall 2i of the ridge l9, such reinforcement 22 being preferably of the same thickness as the ridge l9. Itfwill be apparent that the wall of the cap may be regarded as of uniform thickness throughout except for the extension I! and the thickened rib 20, and except for longitudinal channels or and the thin areas 24 facilitate folding one side portion after the other inwardly toward the central portion of the cap. The lines of this folding involve, also, the ends of the ridge l9 adjacent the front and rear margins and, when thus folded, the cap is considerably narrowed and pointed and fits readily in the hand of the operator, so as to facilitate its insertion through the birth canal. I 7

On its inner surface the cap is provided with a circumferential sealing lip 25 that extends slightly inwardly from the wall of the cap, and with regularlyarranged spacing projections 2-5 of suitable contour that serve to engage and grip the'head of the fetus and at the same time hold the wall of the cap'spaced therefrom, so that the suction will be evenly distributed throughout the area defined by the inner edge of the lip 25. While the spacing projections, or lugs, 26 are shown as rectangular in contour, it will be understood that they may be oval, or in the form of ribs, or of any other shape suitable for distributing the pressure and suction uniformly. At the top of the cap in the construction shown a longitudinally extending rib 2! is preferably provided in place of certain of the lugs, in order to reinforce the cap slightly on that line and prevent accidental closure of the opening to the suction tube or, in the structure shown in Fig. 4, injury to the fetus by the attachment member M. The thickness of the lugs 26 is preferably progressively increased, as shown, from the lip 25 toward the crown of the cap, and it has been found to be preferable that the area of the total surface of the inner surfaces of the lugs and lip that engage the fetus be approximately equal to the total of the area between the lugs. that is, the non-engaging area.

In use, after the cervix is dilatedjthe device is folded by bending in one side after the other toward the central portion whereupon, as stated above, it is relatively compact, pointed, and curved so that it fitsin the palm of the hand with the thumb holding it is folded relation. After insertion, in this folded condition, it is permitted to open to its normal shape and is fitted to the head of the fetus with the suction tube at the back of the head, it being generally advisable to feel about the perimeter of the lip to make sure that no other tissues are involved before applying suction to the cap, and the pressure is reduced, preferably by an electrically operated air pump, to from 6 to 15inches of mercury. If the presentation is not correct, rotation of the fetus to the proper position is effected by applying force to the surfaces of the extension ll, or the lateral surfaces of the ridge I9, the rib 2B and the reinforcement 22, it being evident that the lugs 26 will be held with suii'icient frictional engagement against the head of the fetus by the suction to prevent relative slipping. After proper presentation is effected, or after the cap is thus applied if the presentation is correct initially, a rest is preferably given by reducing the suction to about 3 inches of mercury, or about 1.5 pounds per square inch, which is sufficient to maintain the cap sealed in position. The tractive efforts preferably are timed to assist and simulate the natural efforts, the suction being applied in the same Way as when the cap was applied, and a steady pull of approximately 40 pounds being exerted upon the extension I! for approximately 40 seconds, alternated with rest periods of approximately 2 minutes during which the suction is reduced to a maintenance stage. Only rarely are more than three or four tractive efforts necessary.

The device is particularly useful in the case of premature deliveries, in protecting the head of the fetus from injury by relieving it of much of the pressure, while at the same time assisting in dilation of the birth canal. It will be appreciated that the device may likewise be used to rotate the head laterally, that is, for flexion of the extended head first to one side and then to the other.

While one embodiment of the invention has been described, together with details of a modified means of attaching the suction tube, it will be understood that many other changes in details of construction may be made within the scope of the invention, particularly in the size and form of the projections for frictionally engaging the head of the fetus and holding the Wall of the cap spaced therefrom, and the reinforcement of the cap.

What is claimed is:

1. An obstetrical device comprising a cap of flexible material having an inwardly extending elastic marginal lip and having spaced projections on its inner surface, a flexible tube communicating with the space between said projections and flexible at a point adjacent the outer surface of said cap, and a collapsible manipulating loop of flexible material on the outer surface of said cap.

2. An obstetrical device comprising a cap of flexible material having spaced projections on its inner surface, a flexible tube communicating with the space between said projections and flexible at a point adjacent the outer surface of said cap, the wall of said cap being thickened over a central area extending longitudinally of said cap from the front edge to the rear edge of the cap and thickened over areas laterally spaced from said central thickened area to define side portions that are readily foldable inwardly toward the central portion of said cap.

3. An obstetrical device comprising a cap of flexible material having an elastic margin and spaced projections on its inner surface, a flexible tube communicating with the space between said projections and flexible at a point adjacent the outer surface of said cap, and a reinforcing and manipulating rib on the outer surface of said cap extending longitudinally thereof from a point adjacent one end margin to a point adjacent the opposite end margin with its side edges constituting manipulating abutments, the entire cap being readily flexible.

4. An obstetrical device comprising a cap having an elastic marginal lip and spaced projections on its inner surface, and means for applying suction to the interior of said cap between said projections, the inner surfaces of said projections defining an area equal to approximately half of the inner area of the cap.

RICHARD TORPIN. 

